Numbers accessing HIV care: National Overview

In 2008, 61,213 HIV-infected individuals (of all ages) accessed HIV-related care in the UK in 2008, representing an increase of 8.5% on the number seen in 2007 (56,443) and almost a three-fold increase on the number seen in 1999 (20,099). For the past five years the numerical year-on-year increase has been stable, at about 5,000 additional individuals seen for HIV-related care each year.

Based on these data and UK population estimates, there were 155 individuals (15-59 year olds) receiving HIV care per 100,000 population in 2008. Prevalence was higher among men than women (201/100,000 and 109/100,000 respectively) and higher in London than in the rest of England (504/100, 000 in London compared to 106/100,000 elsewhere in England).

Infection route and ethnicity

In 2008, 50% (30,502) of persons living with diagnosed HIV were men and women infected via heterosexual sex (11,199 and 19,303 respectively) and 42% (25,569) were men infected through sex between men. A small proportion were infected through injecting drug use (2%, 1,489) or mother-to-child transmission (2%, 1,390).

In 2008, just over half (51%; 31,019) of persons accessing HIV-related care were white (where ethnicity was reported) the majority of whom were infected through sex between men (72%; 22,336). Over one-third of persons (37%, 22,282) seen for care were black-African, the majority of these individuals (92%; 20,393) were infected through heterosexual sex.

Figure 1: Diagnosed HIV-infected individuals accessing care by ethnicity, UK: 1999 and 2008 (PDF, 58 KB)

Figure 2: HIV-infected persons accessing care by prevention group and ethnic group, UK (PDF, 64 KB)

Use of antiretroviral therapy

The level of antiretroviral therapy (ART) was reported for 99% (60,805) of people accessing HIV-related care in the UK in 2008. Of these, 72% (44,028) were receiving three or more antiretroviral drugs, 2.4% (1,895) one or two drugs and 27% (16,249) were not receiving therapy. The number of patients prescribed ART has increased over the past decade. In 2008, 75% (45,953/60,805) were prescribed ART, this compared to 71% (39,704/55,757) in 2007 and 64% (12,907/20,099) in 1999.

Figure 3: Diagnosed HIV-infected individuals accessing care by level of antiretroviral therapy, UK (PDF, 58 KB)

Age

The number of HIV-infected children (under 15 years) seen for care has increased in the past decade, from 558 in 1999 to 971 in 2008 but represent a smaller proportion of the total number seen for care, from 2.8% in 1999 to 1.6% in 2008.

Persons aged 55 or older accounted for 9% (5,547) of all persons living with diagnosed HIV in the UK in 2008; this compares to 5% (1037/20,078 where age was reported) in 1999. Within this age-group, just over half (54%; 2920/5413) were infected through sex between men and 43%; 2343/5413) through heterosexual sex (where route of infection was reported).

Figure 4: Diagnosed HIV-infected individuals accessing care by age group and survey year, UK (PDF, 56 KB)

Geography

In England, the strategic health authorities (SHAs) that saw the largest proportional increases in the number of diagnosed HIV-infected individuals seen for care in the past five years were: Yorkshire and the Humber, (from 1,635 to 3,116), and the West Midlands, (from 2,133 to 3,732). London SHA saw the lowest proportional increase (33%, from 20,271 to 26,906).

The proportion of diagnosed individuals who were resident in London continues to decrease, falling from 59% (11,372/19,295) in 1999 to 44% (26,906/60,847) in 2008 (excluding individuals whose place or residence was not known). These trends reflect the increased geographical heterogeneity of individuals living with diagnosed HIV in the UK.

Figure 5: Diagnosed HIV-infected individuals accessing care by place of residence, UK (PDF, 52 KB)

The SHAs with the highest proportion of residents accessing care who were infected through sex between men were the South East Coast SHA (54%; 2,008/3,685) and the North West SHA (52%; 2,564/4,891). In contrast, the East of England SHA and South Central SHA had the highest proportions of residents accessing care who were infected through heterosexual sex (69%; 2,497/3,645 and 67%; 1,846/2,735 respectively) and among the lowest proportions infected through sex between men (26%; 944/3,645 and 27%; 734/2,735 respectively).

Figure 6: Diagnosed HIV-infected individuals accessing care by SHA and prevention group: England, 2008 (PDF, 52 KB)

There were substantial variations in the ethnicity of HIV-infected individuals attending care between SHA. In 2008, 67% (1,735/2,571) of individuals were reported as white within the South West SHA, compared with 40% (1,040/2,613) in the East Midlands SHA. While black-African individuals comprised 35% (21,288/60,308) of diagnosed infected individuals in England, they accounted for only 25% (637/2571) in the South West SHA and 53% (2,073/3,924) in the East of England SHA.

Figure 7: Diagnosed HIV-infected individuals accessing care by SHA and ethnicity: 2008 (PDF, 59 KB)

There is increasing cross-boundary movement between where diagnosed HIV-infected people live and where they go for treatment. A substantial proportion of non-London residents use London HIV services (8.4%; 2,845/33,942) (excluding records where SHA of residence was not reported). The South East Coast SHA has the highest proportion of individuals seen for treatment who were not resident in the region (9.8%; 332/3,387) followed by London (9.6%: 2,845/29,501); the East Midlands SHA had the smallest proportion (2.8%; 65/2,335).

Figure 8: Diagnosed HIV-infected individuals accessing care: London and rest of England (PDF, 54 KB)

In 2006, for the first time, the number of persons receiving HIV care resident outside London (within England) was greater than the number resident in London, this continues to be the case in 2008 (26,906 living in London and 29,526 living elsewhere in England).

Figure 9: Diagnosed HIV-infected individuals resident outside the SHA which provided their HIV care, England 2008 (PDF, 51 KB)

The 2008 UK slides (with accompanying presenter notes) and data tables can be downloaded at the following links:

Suggested citation for reproduction of these graphs: SOPHID, Centre for Infections, Health Protection Agency: 2008.